This page describes how a review on The Designed Edge is put together, so that a reader can judge how much weight it deserves.

The question comes first

Every review begins with a decision a clinician actually has to make, phrased narrowly enough to be answerable. A question that cannot be answered by the literature is still worth publishing — as an essay, where reasoning rather than evidence carries the argument.

Searches are run in PubMed and, where relevant, the Cochrane Library and hand-searched reference lists of key papers. Each review records the databases searched, the terms used, the date the search was run, and the inclusion and exclusion criteria applied. Where a search was limited — to English language, to a date range, to human studies — that limit is stated.

Appraisal

Included studies are described by design, size, population, and outcome measured. Systematic reviews and randomised trials carry more weight than cohort and case-control work, which carries more weight than case series and expert opinion — but a small well-conducted trial in the wrong population is not automatically better than careful observational work in the right one, and reviews say so when that is the situation.

Synthesis

Reviews here are narrative syntheses with an evidence map, not meta-analyses. No pooled effect estimates are calculated. Where the underlying studies disagree, the disagreement is shown rather than averaged away.

Updating

Each review carries the date its search was last updated. When new evidence changes a conclusion, the review is revised and the change is logged in the corrections record rather than made silently.

What these reviews are not

They are not prospectively registered, dual-reviewer Cochrane-style systematic reviews, and they do not claim to be. Where a piece meets a narrower standard than the phrase “systematic review” usually implies, the methods section states the difference explicitly.

The anatomy of a review

Every evidence-format article on this site — systematic review, clinical review, critical appraisal — is built from the same sections, in the same order. The structure is fixed on purpose: it makes reviews comparable to one another, and it forces each one to answer the questions a clinician would otherwise have to ask.

  1. Clinical Question — the decision being examined, stated before any evidence is gathered.
  2. Why It Matters — what hangs on getting it right.
  3. What the Evidence Shows — the findings the literature supports.
  4. What the Evidence Does Not Show — the claims it is regularly stretched to cover, and does not.
  5. How Certain Are We? — the strength and limitations of the underlying studies.
  6. Clinical Interpretation — our reading, marked as reading rather than finding.
  7. What This Changes in Practice — the concrete implication for treatment.
  8. What Remains Uncertain — stated plainly, not buried.
  9. What Could Change Our Conclusion? — the evidence that would move us, named in advance.
  10. Methods — how the literature was identified, selected, and appraised.
  11. References — every source, openable.

The ninth section is the one we would defend hardest. A review that cannot say what would change its mind is not a review; it is an opinion with citations.